This study focuses on reorganizations which have affected the relationships between local health departments and public hospitals since 1950, especially in large urban areas. The study's goals are to provide a base of information and analyses for possible use as guidelines for Federal and local governmental policy with respect to provision by government of ambulatory and primary care for the urban poor. The study's specific objectives include: (a) to determine the nature and extent of current public hospital/health department relationships; (b) to identify the impetus for any major reorganizations of this relationship; (c) to examine the impact of reorganization on primary care; (d) to compare reorganized and non-reorganized situations. The study will utilize a mail questionnaire, bibliographic research; on-site interviews; analysis of agency reports and plans and other relevant local documents. Analysis of the questionnaire will attempt to correlate pertinent variables with a particular type of hospital/health department relationship. The impact on primary care in areas with reorganizations will be assessed using organizational parameters and compared to areas with traditional hospital/health department relationships. The intended outcome of the study is an assessment of the implications of different forms of mergers and reorganizations.